Trends in Suicide Mortality in Canada by Sex and Age Group, 1981 to 2017: A Population-Based Time Series Analysis: Tendances de la mortalité par suicide au Canada selon le sexe et le groupe d’âge, 1981 – 2017 : Une analyse de séries chronologiques dans la population

Abstract

Objectives: Suicide is a complex global public health issue. The objective of this study was to assess time trends in suicide mortality in Canada by sex and age group. Methods: We extracted data from the Canadian Vital Statistics Death Database for all suicide deaths among individuals aged 10 years and older based on International Statistical Classification of Diseases and Related Health Problems, Ninth Revision (E950-959; 1981 to 1999) and International Statistical Classification of Diseases and Related Health Problems, 10th Revision (X60-X84, Y87·0; 2000 to 2017) for a 37-year period, from 1981 to 2017. We calculated annual age-standardized, sex-specific, and age group-specific suicide mortality rates, and used Joinpoint Regression for time trend analysis. Results: The age-standardized suicide mortality rate in Canada decreased by 24.0% from 1981 to 2017. From 1981 to 2007, there was a significant annual average decrease in the suicide rate by 1.1% (95% confidence interval, −1.3 to −0.9), followed by no significant change between 2007 and 2017. From 1981 to 2017 and from 1990 to 2017, females aged 10 to 24 and 45 to 64 years old, respectively, had a significant increase in suicide mortality rates. However, males had the highest suicide mortality rates in all years in the study; the average male-to-female ratio was 3.4:1. Conclusion: The 3-decade decline in suicide mortality rates in Canada paralleled the global trend in rate reductions. However, since 2008, the suicide rate in Canada was relatively unchanged. Although rates were consistently higher among males, we found significant rate increases among females in specific age groups. Suicide prevention efforts tailored for adult males and young and middle-aged females could help reduce the suicide mortality rate in Canada.

Changes over time in means of suicide in Canada: an analysis of mortality data from 1981 to 2018

“…19,20 Recent Canadian research reported rising suicide rates among females aged 10-24 and 45-64 years. 2 Our research suggests that this may reflect rising rates of suicide by suffocation among females younger than 65 years. Substitution of less lethal means of suicide (e.g., poisoning) with more lethal ones (e.g., suffocation) over time among younger females might explain this increase.…”

“…The increasing rate of suicide by suffocation among some sociodemographic groups in Canada may partially explain why the overall suicide rate has not continued to decrease in recent years. 2 Increasing rates of suicide by suffocation have also been observed in other countries; for instance, Norway and the United States. 19,20 Recent Canadian research reported rising suicide rates among females aged 10-24 and 45-64 years.…”

“…he overall suicide mortality rate in Canada is lower than it was a few decades ago, but continued declines have been absent in recent years and the impact of suicide remains high. 1,2 Suicide was the ninth leading cause of death in 2018. 3 More than three-quarters of suicide deaths in Canada are a result of suffocation, poisoning and firearms.…”

“…For instance, females are more likely to self-report thoughts of suicide and to be admitted to hospital owing to self-inflicted injuries, 5,11 while suicide mortality rates are about 3 times higher among males than females in Canada. 2,3,6 Higher suicide mortality rates for males have been observed in almost all countries, 1 and have been attributed, in part, to more lethal means of suicide (e.g., firearms). 5,6,12 Suicide-related behaviour also varies across the lifespan, with the suicide mortality rate tending to be high in middle-aged adults and males older than 80 years, but hospital admissions owing to selfinflicted injuries tending to occur during adolescence (particularly among females).…”

“…5,6,12 Suicide-related behaviour also varies across the lifespan, with the suicide mortality rate tending to be high in middle-aged adults and males older than 80 years, but hospital admissions owing to selfinflicted injuries tending to occur during adolescence (particularly among females). 2,3,5,6,13 Canadian data from 2000 to 2009 indicated that suicide by suffocation was more prevalent among individuals aged 15-39 years, while suicide by firearm was more prevalent among individuals aged 60 years and older. 6 Canadian data for 2001 to 2011 suggested that rates of suicide by firearm and poisoning declined for males aged 15 years and older, but were unchanged among females during this period.…”